SIIReN - System Integration & Innovation Research Network

Primary Health Care System

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“Primary care utilization among adults with dual diagnosis (developmental disability and psychiatric disorder)"
Presenters:  Yona Lunsky, Elizabeth Lin, Paul Kurdyak, Rob Balogh, Jennifer Bennie, Julie Klein-Geltink, Drew Wilton, Alexander Kopp, Centre for Addiction and Mental Health
February 17, 2011


Individuals with dual diagnosis have complex health care needs that require integrated care from both mental health and primary care services. This project describes health care access patterns for people with dual diagnosis. A developmental disability cohort of Ontario adults was created using health administrative data. Nearly half of Ontario adults with developmental disabilities are categorized as having dual diagnosis. Of those, one quarter are categorized as having a serious spectrum illness like schizophrenia or bipolar disorder. Individuals with dual diagnosis are younger than those with mental illness only, more likely to live in rural settings and more likely to live in the poorest income neighbourhoods. These individuals have greater medical comorbidity and complexity than other individuals. Individuals with dual diagnosis appear to have poorer access to primary care and specialist care but better access to psychiatry when compared to individuals with mental illness only. They have higher rates of emergency department visits, suggesting that current primary, specialist and psychiatry care delivery is insufficient to meet their complex needs.

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